Issue: July 2016
May 24, 2016
2 min read
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Clear lens extraction after laser peripheral iridotomy significantly reduces IOP

Issue: July 2016
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Clear lens extraction not only reduced IOP, but also caused angle widening and reduced the requirement for ocular hypotensive medications in eyes with primary angle closure and persistently raised IOP after laser peripheral iridotomy, according to Tanuj Dada, MD, and colleagues in the Journal of Cataract & Refractive Surgery.

Perspective from Carl H. Jacobsen, OD, FAAO

Researchers included 44 phakic eyes of 44 patients older than 50 years with primary angle closure, corrected distance visual acuity of 20/20 or better with a patent laser peripheral iridotomy (LPI) and an IOP of more than 25 mm Hg at least 8 weeks after LPI. All eyes had clear lens extraction by phacoemulsification, and researchers defined success as an IOP less than 18 mm Hg without medications at 12 months.

The mean preoperative IOP of 27.1 mm Hg decreased to 13.2 mm Hg at 12 months. The angle opening distance at 500 µm increased from baseline values at 0 degrees, from 0.104 mm to 0.31 mm, and 180 degrees, from 0.202 mm to 0.412 mm.

The trabecular iris angle also increased at 0 degrees and 180 degrees, according to the study.

Researchers found absolute success in 38 eyes (86.3%).

They noted a significant negative correlation between the lens thickness and the anterior chamber depth and between the lens thickness and the angle opening distance 500 µm from scleral spur at the 0-degree angle.

“There could be merit in proceeding with lens extraction without performing an LPI in eyes with primary angle closure,” the researchers wrote. – by Abigail Sutton

Disclosure: The researchers reported no relevant financial disclosures.